Bullous Pemphigoid and Intravenous Gammaglobulin

Off-label uses of biologics in dermatology: Interferon and intravenous immunoglobulin (Part 1 of 2)

“…Pemphigus foliaceus (PF) is an autoimmune blistering disorder characterized by autoantibodies to dsg 1. There are 3 published case series [252][253][254] and two case reports 255,256 reporting the successful use of IVIG in the treatment of PF. IVIG lowers antibody titers to dsg 1, often making them undetectable.…”

Management of Acquired Bullous Skin Diseases

“…62 Other drugs occasionally used as corticosteroid-sparing agents in patients with severe autoimmune bullous disease include levamisole, 63 antimalarial drugs, 64 and chlorambucil, 65 although none of these are now recommended often. Treatment with high-dose intravenous immune globulin is reportedly ineffective in patients with pemphigus, 66 but it may be beneficial, together with prednisone, in patients with bullous pemphigoid 67,68 or epidermolysis bullosa acquisita 69 who do not respond to or cannot tolerate other therapies. Extracorporeal photochemotherapy was beneficial in a few patients with severe pemphigus vulgaris 70,71 or epidermolysis bullosa acquisita.…”

Comparison Between Intravenous Immunoglobulin and Conventional Immunosuppressive Therapy Regimens in Patients With Severe Oral Pemphigoid

“…11,[14][15][16] Combination therapies can have more adverse effects and mandate careful monitoring. 17,18 Intravenous (IV) immunoglobulin has been successfully used in the treatment of autoimmune and chronic inflammatory disorders, such as idiopathic thrombocytopenic purpura, Kawasaki disease, GuillainBarré syndrome, and dermatomyositis. 19 Since the first report of its use in a few patients with bullous pemphigoid in 1985, 20 several investigators have reported on its efficacy in the therapy of both bullous pemphigoid and pemphigus vulgaris.…”

“…The profile of adverse effects of the drugs used is well known. 11,17,20,28,29 Adverse effects of longterm usage of systemic corticosteroids such as moon faces, buffalo humps, and redistribution of body adipose tissue were excluded from Table 2. The reason for this was that these adverse effects did not necessitate medical therapy, although bothersome to the patient.…”